gms | German Medical Science

Purpose: Prostate cancer is the most common cancer in men in Germany with 40,600 new diagnoses each year. Empirical studies on anxiety in prostate cancer patients find levels of anxiety of up to 36%, and levels of mental distress of up to 47%. However, few studies have analyzed the prevalence of distress and anxiety in these patients – in particular the cancer and treatment-specific anxiety. Unrecognized and untreated mental disorders in cancer patients have a potentially negative effect on the somatic morbidity and mortality, the chronification of the mental illness, the quality of life, the doctor-patient relationship, and compliance, as well as on the duration of hospitalized treatment and the costs of that treatment. This emphasizes the importance of an early identification for distress in particular at the beginning of an oncological rehabilitation measure. Purpose of this study ist the German adaptation and empirical examination of the Memorial Anxiety Scale for Prostate Cancer (MAX-PC), an 18-item scale that measures general prostate cancer anxiety, anxiety related to prostate specific antigen (PSA) levels in particular, and fear of recurrence (three subscales) (Roth et al., 2003; Mehnert & Lehmann, 2005).

Methods: N=106 prostate cancer patients were recruited at the beginning of the oncological rehabilitation measure at the Klinik Bad Oexen, Bad Oeynhausen. Participants completed questionnaires that included the NCCN Distress-Thermometer and the problem list to examine the concurrent validity of the MAX-PC.

Results: The estimates of reliability of the German version of the MAX-PC revealed a high internal consistency for the three MAX-PC dimensions (Alpha=.84, .89, .94) as well as for the total scale (Alpha=.83). The discriminatory power was high ri(t-i)>.45. All of the original three factors were replicated (Principal Components Analysis). Correlations between the MAX-PC scales and the Distress-thermometer were between r=.63 and r=.69 (p<.001). Most frequent problems in prostate cancer patients were sexual problems: (74%), pain (50%), changes in urination (50%) and sleep disturbances (48%). Moderate association were found between the MAX-PC scales and psychosocial distress (p<.05) and strong associations with the frequency of emotional problems (p<.001).

Conclusions: The German version of the MAX-PC appears to be a valid and reliable measure of anxiety in men with prostate cancer.